| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LLC | 655 FOX RUN RD, SUITE A FINDLAY, OH 45840 | GUARDIAN | $10K | $2K | $12K | 11.24% |
| WATCH TOWER BENEFITS3 Filed as: WATCH TOWER BENEFITS LLC | 2734 NORTH MILDRED AVE, SUITE 3 CHICAGO, IL 60618 | GUARDIAN | $2K | — | $2K | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND, LLC | 8044 MONTGOMERY RD, SUITE 640 CINCINNATI, OH 45236 | GUARDIAN | $907 | — | $907 | 0.86% |
| SBR SERVICES LLC3 | 2300 WINDY RIDGE PKWY, SUITE 695S ATLANTA, GA 30339 | HCC LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACRISURE EIN 37-1846319 BROKER | Insurance agents and brokers Service code 22 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | $126K |
| ALLIED BENEFIT SYSTEMS, INC EIN 36-3086057 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Consulting (general) Service code 12 | 200 W ADAMS ST, SUITE 500 CHICAGO, IL 60606 | $120K |
| SHARX LLC EIN 84-3019478 OTHER | Consulting (general); Insurance services Service code 16 | 600 MASON RIDGE CENTER DR ST. LOUIS, MO 63141 | $59K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 PPO | Insurance services Service code 23 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $51K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 0 | $105K |
| Vision | GUARDIAN | 0 | $105K |
| Life insurance | GUARDIAN | 0 | $105K |
| Short-term disability | GUARDIAN | 0 | $105K |
| Long-term disability | GUARDIAN | 0 | $105K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 277 | $970K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 266 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.